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CH09604F COMMUNITY CLINIC OF MAUI, INC. (Active)
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Main Details
Name
COMMUNITY CLINIC OF MAUI, INC.
Subdivision Name
Kahana Satellite
Type
HRSA-Funded Health Center
Site ID
BPS-H80-038692
340B ID
CH09604F
Grant Number
H80CS00722
Additional Details
Current Program Status
Active
Registration Date
10/3/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/10/2024
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
Community Clinic of Maui, Inc.
John Vaz, Chief Executive Officer
(808) 872-1052
Primary Contact
Community Clinic of Maui, Inc
Monique van der Aa, Chief Financial Officer
(808) 872-4017
Addresses
Street Address
10 Hoohui Rd, Ste 305
Lahaina, HI 96761-9259
Billing Address
Community Clinic of Maui, Inc.
1881 Nani Street
Wailuku, HI 96793-1811
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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